At 02:33 AM 3/23/96 -0500, [log in to unmask] wrote:
>This is Chuck, CG for Joyce 52/12/pallidot in 52 days asking for comments re
>strange things Joyce has done in past 24 hours.
>
>background:
>Extreme leg/foot/toe freezing/stiffness/muscle spasms during past 15 days.
> Normal meds in this case in addition to normal pd meds. incl up to 6 Ativan
>.05mg/day
>+ up to 3/day of Percocet 5's.
>She has taken the full amounts and maybe even a few more Ativan's each day.
>
>Has anyone else been through this...Ive checked with both the therapist who
>thinks it is a buildup of the Ativan and the covering neuro who thinks it may
>require additional Clozapin !! Sort of each passing the buck. (I guess they
>dont like being "annoyed" they guys on a Friday night)
>
Chuck and Joyce, these sudden hallucinations most likely are the result of
to much ativan (lorazepam). I have been on them before.... I had
unpredictable attitude changes, so much so that my family called them dad's
'happy pill'. When I finally realized this I quit them..... found out that
the depression was stress related....turned down the stress.
Joyce isn't on Eldepryl is she? Hallucinations were reported by 1/3 of their
test subjects. Dopamine agonists like Parlodel and Permax have reported
incidences also.
Ativan (lorazepam) has a small percentage also.
Treating the dystonia is of primary concern..... dispense rather than take
the ativan at will. At the earliest opportunity when this crisis is
resolved, some of the new SSRIs would be more effective for her rather than
the ativan. If she is still on liquid sinemet, this can create a roller
coaster effect....with the downs being more than the ups. The same toxicity
that causes dyskinesia could be be affecting her dystonia shortly after her
'on' and then worse when she is turning 'off'.
Many times, this phenomena can be minimized if the sinemet tablets are
broken so that a dose can be taken every 3 hours instead of the 3 or 4 times
a day dose....the daily total dose is the same but it is divided into 1 1/2
to 3 hour doses. The length of time that the Sinemet is effective varies
with the day's diet and the progression. The theory is to avoid overdosing
and to continually provide the correct amount of levodopa as needed. This
levels out the hills so to speak. This is the 'pebbles theory'.
Internist do not like to dispense percoset to be taken more than three a day
because of the ADDICTION fear. AMA says that their doctors undermedicate and
undertreat pain..such as the dystonia....In normal subjects...abusers, 75
mgs are needed to produce the abusive effects. If the doctor is rationing
the Percosets.....get one that will let you have what you need. It is the
sinemet and the Percosets that make the dystonia feel better.
Get the dystonia study out of the archives....take it to him and let him
read it....
After the pall, things will get better.....:)....hang in there!
John Cottingham "The parkinsn list brings Knowledge, Comfort, Hope, and
Homeboy Friendship to the parkinsonian world."
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